title: Using medication-assisted treatment for substance use disorders: evidence of barriers and facilitators of implementation.
abstract: The use of medications to treat substance use disorders (SUDs) has emerged as a potentially central part of the treatment armamentarium. In this paper we present data from several recent US national surveys showing that despite the clinical promise of these medications, there has been limited adoption of pharmacotherapies in the treatment of SUDs. The data reveal variable patterns of use of disulfiram, buprenorphine, tablet naltrexone, acamprosate and injectable naltrexone. After examining the environmental and institutional context for the adoption of pharmacotherapies, the specific organizational facilitators and barriers of medication adoption are considered. The paper concludes with a discussion of the minimal clinical and administrative guidance available to enhance adoption, the lack of client and consumer knowledge of medications that puts a brake on their adoption and availability, and the difficulties that must be surmounted in bringing new medications to market.
authors.affiliation: Center for Research on Behavioral Health and Human Services Delivery, Institute for Behavioral Research, University of Georgia, Athens GA 30602, United States; Department of Sociology, University of Georgia, Athens GA 30602, United States.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Roman
authors.affiliation: Center for Research on Behavioral Health and Human Services Delivery, Institute for Behavioral Research, University of Georgia, Athens GA 30602, United States; Department of Sociology, University of Georgia, Athens GA 30602, United States. Electronic address: aabraham@uga.edu.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Abraham
authors.affiliation: Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington KY, United States.
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Knudsen
mesh_terms: D000077443:Acamprosate; D000427:Alcohol Deterrents / Q000627:therapeutic use*; D002047:Buprenorphine / Q000627:therapeutic use; D004221:Disulfiram / Q000627:therapeutic use; D006801:Humans; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010353:Patient Education as Topic; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000188:drug therapy*; D013654:Taurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014481:United States
chemical_list: D000427:Alcohol Deterrents; D009292:Narcotic Antagonists; D013654:Taurine; D002047:Buprenorphine; D009271:Naltrexone; D000077443:Acamprosate; D004221:Disulfiram